POSTER

ABSTRACTS

April 24–27, 2012

AS-277Differences in Clinical and Angiographic Parameters followingIntracoronary Ergnovine and Acetylcholine Provocation Test forCoronary Artery Spasm. Seung-Woon Rha, Byoung Geol Choi,Se Yeon Choi, Amro Elnagar, Sung Il Im, SunWon Kim, Jin Oh Na,Seong Woo Han, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim,Eung Ju Kim, Hong Seog Seo, Chang Gyu Park, Dong Joo Oh.Cardiovascular Center, Korea University Guro Hospital, Seoul,Korea (Republic of).

Background: Ergnovine (Erg) and Acetylcholine (Ach) is an usefulagent for assessing significant coronary artery spasm (CAS). However,a comparison studies of the two agents are limited.

Methods: A total 113 consecutive patients (pts) without significantcoronary artery disease (CAD) who underwent Erg and/ or Ach prov-ocation test between May 2010 and October 2011 were enrolled.Significant CAS was defined as focal or diffuse severe transient luminalnarrowing (�70%) with/without chest pain or ST-T change on ECG.We investigated whether there are differences in clinical and angio-graphic characteristics according to intracoronary Erg or Ach provo-cation test.

Results: Baseline clinical characteristics were similar between thetwo groups except the Erg group had more male gender (69.3 vs.31.6%, � 0.001) and smokers (34.6 vs. 11.6%, �0.001). During theprovocation test, the incidence of ischemic chest pain and ECG changewere not different but AV block during the test was higher with Achprovocation test. More pts responded to lower Ach dose and higher Ergdose to induce significant CAS. Despite of similar incidence of multi-vessel involvement, the incidence of diffuse spasm was higher with Ergtest (Table).

Conclusion: Both Erg and Ach were safe but Ach was more sensi-tive even to lower Ach dose as compared to Erg. Erg test was moreassociated with diffuse spasm whereas Ach was more associated withfocal spasm.

AS-278Combined Intracoronary Ergnovine and AcetylcholineProvocation Test for Assessment of Significant Coronary ArterySpasm. Seung-Woon Rha, Byoung Geol Choi, Se Yeon Choi,Amro Elnagar, Sung Il Im, SunWon Kim, Jin Oh Na,Seong Woo Han, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim,Eung Ju Kim, Hong Seog Seo, Chang Gyu Park, Dong Joo Oh.Cardiovascular Center, Korea University Guro Hospital, Seoul,Korea (Republic of).

Background: Ergnovine (Erg) and Acetylcholine (Ach) is an useful

agent for assessing significant coronary artery spasm (CAS). However,

134S The American Journal of Cardiology� APRIL 2

clinical data regarding combined or simultaneous intracoronary prov-ocation test using these two agents are largely unknown.

Methods: A total 113 consecutive patients (pts) underwent Ergand/ or Ach provocation test were enrolled. Erg test was performedby incremental doses of 5, 10, 25 ug into the left & right coronaryartery. If there is no significant response to Erg, subsequent Ach testwas done by incremental doses of 20, 50, 100 ug. Significant CASwas defined as focal or diffuse severe transient luminal narrowing(�70%) with/without chest pain or ST-T change on ECG. Weinvestigated the overall results of simultaneous Erg and Ach prov-ocation test.

Results: Baseline clinical characteristics showed that mean agewas 53.18 � 9.8 years old (male 69.3%), hypertension 48.7%,diabetes 6.1%, dyslipidemia 12.2% and smoking 34.6%. A total 49pts (49/113, 43.4%) showed (�) provocation test by Erg. Sixteen %of the pts responded to E2 dose (10 ug) and 83.6% to E3 (25 ug).Multivessel spasm was in 32.7%, and diffuse spasm 16.3%. A total64 pts who were (-) to Erg test underwent subsequent Ach provo-cation test. A total 60 pts (60/64, 93.8%) showed (�) provocationtest by Ach. Eleven % of the pts responded to A1 dose (20 ug) and35.0% to A2 (50 ug). Multivessel spasm was in 47.5%, and diffusespasm 8.3%. Only 4 pts (4/113, 3.5%) were (-) response to both Ergand Ach test.

Conclusion: Both Erg and Ach were safe but Ach was more sensi-tive and Erg seems to be more specific to show significant CAS.

AS-279Serum Fibroblast Growth Factor 21 is a Predictable Marker ofCoronary Artery Disease in Type 2 Diabetes Mellitus.A-Ra Cho1, Seung-Woon Rha2, Sang-Ho Park1, Hyeok-Gyu Lee1,Se-Whan Lee1, Won-Yong Shin1, Seung-Jin Lee1, Dong-Kyu Jin1,Amro Elnagar2, Byoung Geol Choi2, Sung Il Im2, SunWon Kim2,Jin Oh Na2, Seong Woo Han2, Cheol Ung Choi2, Hong Euy Lim2,Jin Won Kim2, Eung Ju Kim2, Hong Seog Seo2, Chang Gyu Park2,Dong Joo Oh2. 1Soonchunhyang University Cheonan Hospital,Cheonan, Korea (Republic of); 2Cardiovascular Center, KoreaUniversity Guro Hospital, Seoul, Korea (Republic of).

Background: Obesity, metabolic syndrome and diabetes mellitus arerisk factor of coronary artery disease (CAD). Fibroblast growth factor21 (FGF21) is secreted primarily from liver that exerts potent anti-diabetic and lipid lowering effects in animal models of obesity and type2 diabetes mellitus. In recent studies showed FGF21 has similar effectsin human subjects and also related with obesity and metabolic syn-drome. However, the relationship between serum FGF21 level andCAD is not yet unknown.

Methods: This study aimed to investigate the relationship amongserum FGF21 levels, various cardiometabolic parameters and CADin type 2 diabetic patients. In a total of 168 Korean adults withdiabetes mellitus, in whom coronary angiogram were performed andclassified into CAD group (n � 99) and non-CAD group (n � 69).Significant coronary artery stenosis was defiened as a coronaryangiography finding of more than 50% stenosis in 1 � coronaryarteries. Fasting serum FGF21 level were measured using ELISA.

Results: Serum mean FGF21 level in type 2 diabetes mellitus withCAD showed lower than in type 2 diabetes mellitus without CAD(1.10 � 0.22 pg/mL vs. 1.27 � 0.16 pg/mL, P � 0.05).

Conclusion: The results suggest that fasting serum FGF21 levelsmight be a predictive marker of coronary artery diseases in Korean

patients with type 2 diabetes mellitus.

4–27, 2012 ANGIOPLASTY SUMMIT ABSTRACTS/Poster

POS

April 24–27, 2012

AS-280Impacts of Magnetic Resonance Imaging and Angiography onClinical Outcomes After Coronary Artery Bypass GraftSurgery. Sun-Joo Jang, Won-Jang Kim, Yong-Kyu Park,Gyung-Min Park, Yong-Giun Kim, Jung-Min Ahn, Jong-Young Lee,Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim,Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park. AsanMedical Center, University of Ulsan College of Medicine, Seoul,Korea (Republic of).

Background: Patients undergoing coronary artery bypass graft(CABG) often have intra- and extracranial atherosclerosis, regarded asimportant risk factor for stroke. There was limited data regardingpre-CABG magnetic resonance angiography (MRA) for intra- andextracranial arterial atherosclerosis.

Methods: Between Jan. 2003 and May 2009, 3,071 patients under-going CABG were analyzed. MRA was done in 2417 patients (groupA) and 172 patients (group B) had no image evaluation before CABG.We compared clinical outcomes (death, stroke, total operation time,intensive care unit stay, and prolonged ventilation support) duringin-hospital stay, 30-day, and 3-year after CABG.

Results: Group A had more old age, diabetes, hypertension, hyper-

lipidemia, unstable angina, and left main or 3 vessel disease than group

The American Journal of Cardiology� APRIL 24–27, 2012 AN

B. Group B had more NSTEMI, STEMI, emergent operation, cardio-pulmonary bypass, combined cardiac or thoracic aorta operation thangroup A. Group B had more inhospital, 30-day and 3-year death,cardiac death, and death/stroke compared with Group A (Figures A, B,and C). Compared with group A, group B had more prolonged totaloperation time (300.1�93.6 min vs. 325.1�105.2 min, p�0.001),intensive care unit stay (4.1 days �5.3 vs. 7.3 days �11.6, p�0.001),low cardiac output syndrome (30.1% vs. 44.8%, p�0.001) and pro-longed ventilation support (6.5% vs. 28.5%, p�0.001).

Conclusion: Preoperative brain MRA evaluation may have a rolein reducing adverse clinical outcomes in patients who undergoingCABG.

GIOPLASTY SUMMIT ABSTRACTS/Poster 135S

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